Open defecation is more than a sanitation problem

Open defecation is more than a sanitation problem

Rukhsat Hussain holds a masters degree in Human Rights from Aligarh
Muslim University. He is working as a Senior Research Associate at
Research Monitoring and Evaluation center of the SM Sehgal Foundation.
His areas of expertise include qualitative and quantitative research on
water, and sanitation.

“I make my children sit on the wooden legs of the cot if they get
nature’s call at night so that the pressure can go up, because I cannot
take my young kids for defecating alone at night,” explains Kanta of
Hamirpur village in the Alwar district of Rajasthan.

Introduction

India has far higher open defecation rates than other developing
regions where people are poorer, literacy rates are lower, and water is
relatively scarcer (Diane Coffey et.al, 2017). Improving sanitation is
crucial to gear the development process in India whose sanitation
performance has been unsatisfactory even after a program for better
sanitation has been in place since 1986. With the ever-growing
population, the government and civil society continue to grapple with
the issue of sanitation taking into cognizance that 53 percent Indian
households still do not own a toilet (Census, 2011). Poor sanitation is
an issue that affects everyone but women are often the most at risk.
Open defecation is more than a sanitation issue—the lack of a safe,
clean and secluded space to defecate specifically hurts women by
drastically limiting their daily freedom. “Women in India who practice
open defecation are prone to sexual violence and infrastructure
improvements can provide them with some level of protection,” (The
Indian Express, 2016).

Women suffer

Kanta’s solution for the lack of safe spaces for defecation is
certainly not uncommon. On a recent Sehgal Foundation research team
visit to the five-villages[1]Samra Panchayat
(village council) in Thanagazi block, many women described similar
issues relating to open defecation. In this block, only five out of
1,409 households[2]
had toilets before 2014, and those five were nonworking. Women
described avoiding defecation in the dark due to their fear of wild
animals, such as lions, boars, etc., in the nearby jungle, and there is
no other place available. Men never accompany them and they often feel
too shy to ask other women to accompany them. Several women either do
not eat or reduce their food intake to half after dark to avoid the need
to defecate.

The unease for girls, new mothers, and elderly women

Young girls must go even farther away during their menstruation,
searching for isolated places where male members of the family cannot
see them defecate. They are always wary while changing clothing as well.
The absence of toilets further worsens the plight of ill and pregnant
ladies who cannot walk long in search of a place to defecate. Elders and
women suffering from diarrhea are therefore forced to defecate close to
the houses, leaving a bad smells behind and fecal matter that becomes a
breeding place for houseflies/insects, which puts the health of
everyone in the family at risk.

The other side

Meanwhile, men seem to be comfortable defecating openly. Being
farmers, they need to visit their crop fields early in the morning,
which is the preferred defecation time for most adult men. They do not
wait for someone else to accompany them to defecate or wait for the
cover of darkness as women usually do. Unlike women and girls, males do
not “schedule” defecation but rather defecate whenever the need arises,
either on their way to or returning from their fields.

Discussions also revealed that inhabitants have different views about
the construction of toilets. The figure below shows the common and
differentiating factors that support and resist toilet construction as
perceived by men and women.

The population has not been made aware of all the initiatives taken
by the government of India to encourage toilet construction. The
Government of India has launched various sanitation programs starting
with the Central Rural Sanitation Program in 1986 to the Swachh Bharat
Mission in 2014 to promote toilet construction because it affects the
dignity of women and girls the most. The Swachh Bharat Mission to clean
India’s cities and villages provides a revised monetary incentive to
individuals who live below the poverty line and identified
above-poverty-line households. This includes up to INR 12,000 for the
construction of one individual household latrine with water
availability, including water for hand washing and cleaning of the
toilet.

Reaping results of effective mobilization

IEC Pamphlet 1

The Sehgal Foundation, in collaboration with the Coca-Cola India
Foundation, intervened in these villages in 2014 with the aim of
mobilizing and sensitizing communities towards health and sanitation
issues leading to toilet construction. Foundation staff used information
education and communication materials such as pamphlets designed in an
easily comprehensible manner by the community for conducting trainings
on the benefits of constructing toilets, emphasizing clean surroundings,
safety, and ease of use. These trainings were conducted every month
separately for males and females in the villages to address the
sanitation issues and spread awareness about the Swachh Bharat Mission
and its monetary incentives for toilet construction.

IEC Pamphlet 2

The outcome of this community mobilization and awareness has been
toilet construction in 25 to 30 percent of the households. However, some
of the households with toilets are not using them indicating that
understanding the motivation for using a sanitation facility is as or
even more important than access to the sanitation facility. Open
defecation continues to be a socially and culturally accepted
traditional behaviour by the community. Females reported that males are
often not supportive of toilet construction, but some women mentioned
that lack of water and money prevents us from not having a sanitation
facility.

A long way to go

Sehgal Foundation mobilized and sensitized the community towards
health and sanitation issues and as a result the community started to
construct and use toilets. Our learning from the project is that the
major thrust of all sanitation campaigns should be to promote
attitudinal change that will create demand and further lead to improved
access. In the long term, behavioral change communication, which varies
across age and gender, is imperative to sensitize people to use
sanitation facilities and appreciate the positive aspects associated
with it. Any sanitation intervention, instead of merely achieving
targets, needs to consider the above aspects to develop adequate and
holistic approaches to behavioral change in sanitation.